What Are Atrial And Ventricular Septal Defects
Atrial septal defects (ASDs) and ventricular septal defects (VSDs) are holes that develop in the septum. The septum is a wall that separates the heart’s two sides. It keeps the blood on the right side from mixing with blood on the left. When one or more holes develop in the wall, blood from both sides mixes. This presents problems that may become fatal without treatment.
Most people with ASDs and VSDs are born with them; the condition is a congenital defect. Below, we’ll describe different types of septal defects as well as the symptoms they cause. Before we do so, however, it’s helpful to be familiar with the function of a normal (i.e. defect-free) heart.
How A Normal Heart Works
Each side of the heart has an atrium and ventricle. The former is positioned above the latter. When the right ventricle contracts, it pumps blood toward the lungs, where it picks up oxygen. The blood then leaves the lungs, and enters the left atrium. The left atrium pumps it into the left ventricle, which in turn pumps it to a large artery called the aorta. The aorta takes the oxygen-rich blood to other areas of the body.
This process works seamlessly as long as the heart is healthy. The atria’s contractions send blood to the ventricles. The ventricles’ contractions send blood out of the heart. While this happens, oxygen-depleted blood on the right side is kept separate from oxygen-rich blood on the left side.
Types Of Holes In The Septum
There are three types of atrial septal defects and four types of ventricular septal defects. Each is categorized based on where the hole is found in the septum. With ASDs, a hole in the top portion of the wall that separates the atria is called a sinus venosus. Very few babies are born with this type of defect. When the hole is found in the middle of the wall, it is called a secundum. This is much more common. Lastly, a hole in the lower portion of the wall is called a primum. Similar to a sinus venosus, it affects very few newborns.
The least common type of ventricular septal defect is an outlet VSD. It appears near the point where blood exits the chamber on the way to the lungs or aorta. An inlet VSD is found where blood enters the chamber from one of the atria. It too is uncommon. Membranous VSDs can be found next to the heart valves while muscular VSDs appear in the bottom part of the ventricular septum.
What Are The Symptoms Of A Septal Defect?
Small holes are often without symptoms. In fact, if a child’s parents choose not to tell him about the defect, he may never become aware of it later in life. In many cases, the only sign that a hole exists is a heart murmur, which is only noticeable when listening through a stethoscope.
Large holes, on the other hand, usually present problems that worsen with time. For example, as a teenager or adult, the patient may experience constant fatigue, an arrhythmia, or fluid buildup in the feet and legs. If a hole between the ventricles is large, it may even produce signs of heart failure early in life. Complications from large ASDs and VSDs include endocarditis as well as a higher risk of stroke.
Repairing ASDs And VSDs
An atrial septal defect can often be repaired without surgery. Doctors can use a catheter to apply a patch to the hole if it appears in the middle of the wall (i.e. a secundum ASD). The tissue grows over the patch during the following months. The other two types of ASDs are best patched via surgery since both are difficult to reach with a catheter.
A ventricular septal defect is handled differently. Rarely can a catheter be used to apply a patch. If a patient is suffering from symptoms of heart failure, surgery is typically performed. Otherwise, doctors prefer to monitor the defect in the hopes that it closes without intervention.
ASDs and VSDs that fail to close on their own usually require ongoing checkups. This helps doctors identify problems before they lead to serious complications.
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